Delegate Proposes "Gravely Disabled" Standard, Needs Your Help

On Feb. 8, 2013, Maryland Delegate Michael Hough (R-Frederick and Washington Counties) introduced HB 1258, legislation to expand hospital commitment criteria in Maryland so that a person in desperate need of treatment can qualify for it before becoming violent or suicidal. 

The bill would make explicit that commitment is appropriate when a person is “gravely disabled,” which is defined as “incapable of making an informed decision … [and] unlikely, without the supervision and assistance of others, to satisfy [his or her] need for nourishment, personal or medical care, shelter, or self-protection and safety.”

The need for legislative reform of this kind is well known to the countless Maryland families who have struggled to secure hospital care for their loved ones, only to be turned away because the person wasn’t yet “dangerous” enough. While similar bills have failed in Maryland before, there is reason to hope that this year will be different. The recent spate of mental illness-related preventable tragedies (including Monday’s shooting in College Park) has created extraordinary interest in mental health reform in many states. Maryland is among them and is certainly overdue for change, with some of the worst civil commitment laws in the country. Adding a "gravely disabled" standard would be a huge sterp in the right direction. 

The House of Delegates Health Committee will hear testimony on the bill in Annapolis on Tuesday March 5 at 1:00 pm. If you have a compelling story demonstrating how this reform would help you or a loved one, or if you are a caregiver who sees the benefit to your patients, please consider sharing your insights at the hearing.


  • Write, call or email your delegate to urge him/her to support HB 1258, and your senator to urge him/her to “cross-file” the bill.
  • If you are able to testify at the House Health Committee hearing on March 5, contact Delegate Hough’s office ASAP.
  • Write a letter of support to the editor of your local newspaper.
  • Forward this message to your Maryland friends and neighbors, and use social media to rally the troops.

In all of these activities, emphasize the difficulties you have faced in seeking treatment from Maryland’s broken mental health system, and how a “gravely disabled” commitment standard would have made a difference. And please  This e-mail address is being protected from spambots. You need JavaScript enabled to view it  about your efforts and any results.

Maryland, like every state, has its own civil commitment laws that establish criteria for determining when court-ordered treatment is appropriate for individuals with symptoms of severe mental illness who meet strict legal criteria.   


Maryland is one of only five states that do not authorize involuntary treatment in the community, often called “assisted outpatient treatment (AOT) ” or “outpatient commitment.” Such laws often make it possible for people with mental illness to receive medical care before they are so ill they require hospitalization or experience other consequences of non-treatment.   


For inpatient treatment, a person must meet the following criteria:

  • be a danger to self/others;
  • be in need of treatment; and 
  • be unable or unwilling to be voluntarily admitted

State standards for emergency hospitalization for evaluation and state-by-state information on initiating emergency hospitalization and assisted inpatient or outpatient treatment can be found from our Civil Commitment Laws and Standards page. 


Visit Get Help for tools and information about preparing for and handling a psychiatric crisis.

Visit Get Involved for information about how you can help bring down barriers to the timely and effective treatment of severe mental illness.


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